South-East European Cooperation Process ROMANIA South-East European Cooperation Process (SEECP)

South-East European Cooperation Process Romania in SEECP  NATO considered the SEECP activity complementary to its own actions of maintaining peace, stability and security in South-Eastern Europe  EU also included the SEECP on the participants list to the Stability Pact for South Eastern Europe (Cologne and Sarajevo, June-July, 1999).  the most important contribution of the Romanian CiO was the signing of the "Charter on Good-Neighborly Relations, Stability, Security and Cooperation in South-Eastern Europe" (Bucharest, February 12, 2000), which is the fundamental document of this regional structure of co-operation.

South-East European Cooperation Process Romanian PH System  Since 1990 Romanian health sector has begun its slow transition from a centralized system, to a social health insurance system  Since 1995, regulations with major impact on the health system at all levels have been adopted  In 2006 a comprehensive legislative package replaced almost all the reform initiatives and decisions: the Health Reform Law no.95/ For the first time, all reform regulations are included in a single document, structured on levels of healthcare and major topics regarding the system reform.

South-East European Cooperation Process Health status of the population Significant problems:  CVD mortality rates have increased from 1996, the main killer being ischemic heart diseases and cerebro- vascular diseases  Cancer mortality rates showed also an increase, in particular breast cancer, cervical cancer, colorectal and lung cancers  The incidence of tuberculosis increased from 64.6%000 in 1990 to 105.7%000 in 2005  The incidence HIV/AIDS increased from 6.5%000 in 1990 to 45.4%000 in  Missing of a management plan for reduction of air pollution

South-East European Cooperation Process Health status of the population Areas of success:  Implementation of the Phare project ‘Improvement of Health Status Monitoring and Evaluation Capacity in the Framework of Health Care Reform RO 2002/ with creation of the National Centre for Prevention and Control of Communicable Diseases  Life expectancy at birth increased from (males) and (females) in 1990 to (males) and (females) in 2005  Infant mortality decreased from 24.1%0 in 1990 to 12.4%0 in But respiratory disease, especially pneumonia, still remain the main cause of death in children  Infectious and parasitic diseases decreased from 19.2%000 (male) and 7.1%000 (female) in 1990 to 18.3 (male) and 6.0 %000 (female) in 2005

South-East European Cooperation Process Governance and Policy in the field of Public Health Services Significant problems:  Mobilization of community participation for the identification of health needs  The insufficient development of protocols for common use of standards and databases interfaces. It is necessary in order to prevent inconsistencies in reporting, the losses of data sources and multiple requests of the same data  Surveillance of non-communicable diseases remains a problem for the policy makers  The insufficient number of personnel in health promotion;

South-East European Cooperation Process Governance and Policy in the field of Public Health Services Areas of success:  Development of policies, strategies and public health programmes - National Health Programs Agency from Ministry of Public Health ;  Epidemiologic surveillance, prevention and control of diseases - The National Centre for Control of Communicable Diseases;  The Health Insurance Law provides the framework for free market and competition within provided health services;  Integration of public health concepts, findings, evidences into policies and local strategies for health programs;  The new strategy for decentralization of the Ministry of Public Health is in course of elaboration;  The basic services package is stated in legislation and it is accessible to every person insured.

South-East European Cooperation Process Socio-economic factors, focusing on the social determinants of health Weak points  An insufficient and over used technology  The poor population with a low health status  Not all quantitative socio-economic indicators are presented in a systematic way in order to enable predictions and comparisons

South-East European Cooperation Process Socio-economic factors, focusing on the social determinants of health Strong points:  Macroeconomic stability  The majority of population is open to make qualitative and quantitative changes in order to improve their quality of life  New financial sources and resources for Romania as a EU Member

South-East European Cooperation Process Conclusions  Regional cooperation in health is important for the SEE countries desiring to become EU Members  Health has an important contribution to the economic development of the countries  Understanding the challenges in reforming and developing the public health services, as well as the opportunities available to improve the health of the population will help to build appropriate policies, systems and services for the development of PHS in the SEE region.